How Much Is That CT Scan In the Window?

transparencyDo you know how much that 50-inch, flat-screen TV cost? How about your car? The cashmere cardigan you just had to have?

So how much did that visit with your gyn because of your painful period cost (men: substitute whatever you want here)? The ultrasound to see if you had a fibroid? The myomectomy to remove the fibroid?

A few years ago it didn’t matter so much; most of us only had to handle relatively small copayments and many of us didn’t even have deductibles. Fast forward to today, when the cost job-based health insurance has grown faster than our incomes, essentially eating up any salary increases over the past 10 years. In fact, the average deductible has more than doubled for most employees regardless of the size of their companies.

Note I said the past 10 years. Which means you can’t blame the five-year-old Affordable Care Act entirely. In fact, out-of-pocket payments would likely be higher without the ACA; a recent report from the Commonwealth Fund found a “marked slowdown in premium growth in 31 states and the District of Columbia.” However, that same report also found that premiums increased about 10 percent a year in 10 states.

One way employers have tried to rein in these increases is by passing more of the actual cost of health care onto us.

Which, I posit, is a good thing.

Wait! Before you start throwing things at your computer and decide that all this health policy stuff has finally sent Deb off the deep end, let me explain.

Most economists agree that one reason for our country’s outrageous healthcare costs is that the end user – that would be us – has never had to pay for much. Ergo, who cares what it costs? Ergo, there was no incentive for competition or for us to shop around for the best deal (note: expensive does not equal quality in health care – but that’s something for another blog). Nor was there any reason for providers to try and compete for patients based on price.

Now that’s ending.

Today, about a third of firms that provide health benefits offer a high-deductible plan; 45 percent of those with 1,000 or more employees, according to the Kaiser Family Foundation. Some employers fund an account to help you meet that deductible; others don’t. The average annual deductible per person is about $2,000; about $4,500 per family.

So now many of us are finding that we have to pay thousands of dollars out of pocket before we get first-dollar coverage. Now we have a reason to ask what an office visit, procedure, test, or hospitalization costs. For instance, I didn’t realize that I had to pay 20 percent of a CT scan. I sure found out when I got the bill. Had I known that, I would have shopped around.

It’s called transparency. And it’s coming to a health system near you.

I’ll write more about this in another blog; but for now, I want you to start doing one thing. Before you agree to any non-emergency medical services, ask one question:

“How much will this cost.” If they won’t tell you, then go to the competition. I bet they will.

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